Living Wills Offer Death With Dignity

March 6, 1990|By Cory Jo Lancaster of The Sentinel Staff

MELBOURNE — Ten years later, Nan Womack-Wagner still cries when she talks about it.

The memories flash back quickly - her 84-year-old mother lying in a nursing home bed with her arms tied to the bed so she couldn't rip the feeding tubes out of her nose. Like most children, Womack-Wagner never wanted to see her parents that way.

Her mother suffered from advanced stages of Alzheimer's disease, had undergone a mastectomy for breast cancer and then suffered a form of stroke that required one eye to be sewn shut.

''The last few months, she was lying in a fetal position - totally oblivious,'' Womack-Wagner said. ''She would keep pulling the feeding tube out, so they tied her hands down to the bed. She just lied there moaning.''

After consulting with other family members, she asked the doctor to disconnect the feeding tube and end her mother's life.

''The doctor said it was his job to keep her alive,'' Womack-Wagner recalled. ''And I said, 'I beg to differ. You're not keeping her alive. You're keeping her heart beating.'

''The doctor never said anything, but he never put the tube back in her nose . . . About three weeks later she died,'' she said.

Many doctors and hospitals would not have followed Womack-Wagner's wishes. Her mother never filled out a living will, a document that allows people to decide what medical treatment they want. But even if she had, the laws governing the documents still are fuzzy.

Cases are pending before the U.S. and Florida Supreme Courts in which parents or relatives have fought unsuccessfuly to end a loved one's life.

Those courts, which are expected to decide the cases soon, will clarify what rights people have to refuse extraordinary medical procedures used to prolong their life.

As it is, competent adults in Florida can prepare a living will to prevent doctors from artificially prolonging their lives in cases of terminal illness or when there is no reasonable chance of recovery.

But lower courts in Florida have ruled that provision doesn't allow feeding tubes to be removed. The question now is before the state Supreme Court.

In the U.S. Supreme Court case, parents of a Missouri woman who has been in a coma for three years want to end her life. The woman didn't have a living will but told a friend once that she never wanted to be ''a vegetable.''

''Politicians and institutions are very slow on this,'' said Derek Humphry, founder of the National Hemlock Society. ''They are opposed to this, not the people.''

For example, polls consistently have shown that 65 percent of the public and 60 percent of doctors agree that patients should be able to end their lives with the help of their physicians in cases of terminal illnesses, Humphry said.

Thirty-eight states and the District of Columbia have some kind of Living Will law, although only a handful allow people to designate a person to make medical decisions for them if they become incompetent or unable to physically express their wishes. Called durable power of attorney, it is not recognized by the courts in Florida.

For Womack-Wagner, a member of the local Hemlock Society, filling out a living will makes sense for two reasons. First, she doesn't want to suffer through a prolonged terminal illness. But she also doesn't want a family member to decide at what point she should die.

Spelling out what medical procedures a person does and doesn't want alleviates the burden for loved ones, who often feel guilty after making the decision for someone else, advocates say.

''Living wills aren't something you do and then forget about,'' said Bill Ranck, who heads the local Hemlock Society chapter. ''There are a lot of pitfalls and loopholes in the laws. There can be a lot of suffering for the individual and the family. And these illnesses are very costly.''

Ranck recommends people fill out a living will and then initial it yearly to show that it still represents their wishes. People should keep the original copy but should give copies to their doctor or a local hospital, he said.

Jess Parrish Memorial Hospital, Cape Canaveral Hospital and Wuesthoff Memorial Hospital give out living wills to patients upon request and keep them in their files for a period of time.

If properly filled out, the hospitals will honor the wills if two physicians agree that a person's death is imminent or that the person will not recover, hospital spokeswomen said. Holmes Regional Medical Center did not respond to questions about living wills.